| Symptomatic patients with intraluminal carotid artery thrombus: outcome with a strategy of initial anticoagulation. | |
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MedLine Citation:
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PMID: 23061393 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Object The aim of this study was to define the optimal treatment for patients with symptomatic intraluminal carotid artery thrombus (ICAT). Methods The authors performed a retrospective chart review of patients who had presented with symptomatic ICAT at their institution between 2001 and 2011. Results Twenty-four patients (16 males and 8 females) with ICAT presented with ischemic stroke (18 patients) or transient ischemic attack ([TIA], 6 patients). All were initially treated using anticoagulation with or without antiplatelet drugs. Eight of these patients had no or only mild carotid artery stenosis on initial angiography and were treated with medical management alone. The remaining 16 patients had moderate or severe carotid stenosis on initial angiography; of these, 10 underwent delayed revascularization (8 patients, carotid endarterectomy [CEA]; 2 patients, angioplasty and stenting), 2 refused revascularization, and 4 were treated with medical therapy alone. One patient had multiple TIAs despite medical therapy and eventually underwent CEA; the remaining 23 patients had no TIAs after treatment. No patient suffered ischemic or hemorrhagic stroke while on anticoagulation therapy, either during the perioperative period or in the long-term follow-up; 1 patient died of an unrelated condition. The mean follow-up was 16.4 months. Conclusions Results of this study suggest that initial anticoagulation for symptomatic ICAT leads to a low rate of recurrent ischemic events and that carotid revascularization, if indicated, can be safely performed in a delayed manner. |
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Authors:
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Ananth K Vellimana; Yasha Kadkhodayan; Keith M Rich; Dewitte T Cross; Christopher J Moran; Allyson R Zazulia; Jin-Moo Lee; Michael R Chicoine; Ralph G Dacey; Colin P Derdeyn; Gregory J Zipfel |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-10-12 |
Journal Detail:
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Title: Journal of neurosurgery Volume: - ISSN: 1933-0693 ISO Abbreviation: J. Neurosurg. Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-10-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0253357 Medline TA: J Neurosurg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Departments of Neurological Surgery and. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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